Edge wrapping for casts and method for using same

ABSTRACT

There is disclosed an edge wrapping for use in making casts. A strip of material is wrapped around each end of the part to be casted; thereafter, a soft lining and the cast material are applied, and the free edge of each strip is folded back and embedded in the cast material. By using edge wrapping strips, as opposed to the conventional cylindrical wrapping (commonly called &#39;&#39;&#39;&#39;stockinette&#39;&#39;&#39;&#39;), the disadvantages of the latter are avoided and a number of advantages are obtained.

United States Patent [191 Laico [111 3,826,252 [451 July 30, 1974 EDGEWRAPPING FOR CASTS AND METHOD FOR USING SAME [76] Inventor: Joseph P.Laico, 9 Ardsley Dr., New

City, NY. 13214 [22] Filed: July 14, 1972 [21] Appl. N0.: 271,769

{52] US. Cl. 128/91 R, 128/83 [51] Int. Cl. A61f 5/04 [58] Field ofSearch 128/91, 90, 89, 87, 84, 128/83, 82

[56] References Cited UNITED STATES PATENTS 3,643,656 2/l972 Youngl28/90 FOREIGN PATENTS OR APPLICATIONS 657,4l9 2/l963 Canada ,.L 128/90327,909 2/1958 Switzerland l28/90 Primary E.raminer- Richard A. GaudetAssistant Examiner-J. Yasko Attorney, Agent, or Firm-Gottlieb, Rackmun &v

Reisman [57] ABSTRACT There is disclosed an edge wrapping for use inmaking casts. A strip of material is wrapped around each end of the partto be casted; thereafter, a soft lining and the cast material areapplied, and the free edge of each strip is folded back and embedded inthe cast material. By using edge wrapping strips, as opposed to theconventional cylindrical wrapping (commonly called stockinette), thedisadvantages of the latter are avoided and a number of advantages areobtained.

7 Claims, 12 Drawing Eigures EDGE WRAPPING FOR CASTS AND METHOD FORUSING SAME This invention relates to casts such as are used inorthopedics and other fields of medicine, and more particularly to edgewrapping therefor.

The conventional practice in making a cast includes the initial step ofrolling a cylinder of material commonly referred to as stockinette, ontothe desired area. The stockinette, which is a unitary, open-ended,cylindrically shaped element serves to provide an edge at each end ofthe cast. After the stockinette isplaced over the part to be casted, asoft lining'material is applied over the stockinette, such that a lengthof stockinette is left free at either end. The lining serves as apadding and consists of cotton or similar material. The plaster is thenapplied over the lining, and the free ends of the stockinette can berolled back over the ends of the plaster and then incorporated in thecast by subsequent application of more plaster. This prevents the edgesof the cast from digging into the patients skin, provides firm edges,and makes the cast neat in appearance.

However, the portion of the stockinette along the main central length ofthe cast serves little useful function. In fact it has manydisadvantages. Because the stockinette can adhere to the skin, it makesremoval of the cast more difficult. The stockinette is not highlyabsorbent and it therefore causes perspiration to accumulate under it,causing itchiness and general discomfort. The stockinette is alsoinstrumental in prolonging the time required to apply the cast, and itmay also cause the patient considerable pain as it is. rolled over atender area. The conventional stocking type material is produced in onlycertain predetermined circumferences, so that when applied onto thedesired area it may fit poorly. It it is too tight there may not only bediscomfort to the patient but there may also be restriction of blood andlymphatic circulation. If the stockinette is too loose, it may wrinkle,which in turn can cause skin irritation, discomfort and possiblyulceration.

It is a general object of my invention to overcome the aforesaidshortcomings of prior art techniques for making casts.

It is another object of my invention to provide an edge wrapping forcasts which, in addition to not exhibiting the prior art shortcomings,offers certain positive advantages when used.

It is another object of my invention, in one embodiment thereof, toprovide a combination edge wrapping and splint in order to simplify themaking of a cast for a part requiring a splint.

In accordance with the principles of my invention,I utilize a strip ofcloth, gauze, plastic, paper material, etc. at each of the two ends ofthe cast for the purpose of providing an edge wrapping. Unlike the priorart, the central portion of the part to which the cast is applied is notcovered by the material, nor is a cylindrically shaped element utilized.Each edge wrapping consists simply of a piece of material which can becut to a length approximately equal to the circumference of the part towhich it is being applied. (Similarly, an edge wrapping may also be usedwherever there is an opening in the cast to allow the cast to conform tothe part to which it is being applied, e.g., at the opening for thethumb in the case of an arm cast.) The edge wrapping 2' isapplied inessentially a full turn, and may be held in place by adhesive materialwhich may be part of the wrapping, or it may be held in place by abinding such as tape, etc. The conventional cotton or cotton-likematerial is placed around the desired area after the edge wrappings havebeen applied. The plaster is then applied, with the edge wrapping ateach end being turned back over the end of the cast and incorporated init as is conventional practice when a stockinette is used. The edgewrapping of my invention overcomes all the prior art disadvantagesenumerated above.

In one embodiment of the invention, I provide a strip of compressiblematerial such as foam rubber, dense cotton, flannel, etc. secured toeach edge wrapping piece along a line approximately at its center. (Theedge wrapping of my invention can be supplied in rolls as is theconventional surgical gauze. The same is true even when the additionalcentral strip is provided.) When a length of the edge wrapping is cut,it is placed on the part to be casted as before, with the central stripseparated from the patients skin by the wrapping. The central strip isof such a width that part of it encircles the patients limb (or otherpart being immobilized), and part of it covers the edge of the paddingand plaster when folded back. The additional strip at each end of thecast serves not only as a cushion for the cast, but as a seal, by virtueof the compressed material and adhesive (if provided) between wrappingand skin, to prevent foreign materials, including liquids, from beingintroduced into the space between skin and lining.

In another embodiment of my invention, the edge wrapping has attached toit, or incorporated in it, a piece of firm material to provide support,e.g., to act as a splint, for the toes or the fingers. The edge wrappingmaterial is configured so that part of it can be turned back to form anedge for the cast from which the splint extends. The major advantage ofproviding a unitary edge wrap-splint combination is that it permitsmaking a cast including a splint in one operation.

Further objects, features and advantages of the invention will becomeapparent upon consideration of the following detailed description inconjunction with the drawing in which;

FIG. 1 depicts a prior art cast applied to the arm of a patient;

FIG. 2 is a sectional view through the line 2-2 of FIG. 1 in thedirection of the arrows;

FIG. 3 depicts a cast made in accordance with the principles of myinvention applied to the arm of a patient;

FIG. 4 is a sectional view through the line 4-4 of FIG. 3 in thedirection of the arrows;

FIG. 5 depicts a preferred form of edge wrapping material which isprovided with a sealing and/or cushioning strip along the centerthereof;

FIG. 6 is a fragmentary sectional view of a cast made using the edgewrapping material of FIG. 5;

FIG. 7 depicts a combined splint and edge wrap which can be used inmaking a cast for the foot; and

FIGS. 8-12 depict successive stages of formation of a foot cast usingthe combined edge wrap and splint of FIG. 7.

The first step in making the prior art cast 18 of FIGS.

1 and 2 is to apply stockinette 20 on the patients arm 16. Most of thestockinette, as symbolized by the numeral 20a, bears against thepatients arm after the east is applied; it is only the ends 20b of thestockinette which are folded back to form the edges 200 for the cast.After the stockinette is placed on the patients arm, cotton 22 orsimilar padding material is applied around it, following which theactual cast material 24 (e.g., plaster of Paris) is applied around thecotton or similar padding material in layered form. After the initiallayers of the plaster material are applied, the ends 20b of thestockinette are folded back, and they are then covered by the additionallayers of plaster material which are applied. As seen in FIGS. 1 and 2,the stockinette forms a cuff-like edge at each end of the cast.

To make the cast 30 of FIGS. 3 and 4 in accordance with my invention, 1do not use a stockinette of predetermined diameter. Instead, a strip ofcloth or pliable material such as paper, plastic, etc. 32 is wrappedaround the patients arm 16 in the vicinity of each end of the cast to bemade. The length of each strip approximates the circumference of thepatients arm in the vicinity where it is applied, and each strip may beheld in place on the arm by an adhesive or by a strip of tape (notshown). Thereafter, the rest of the cast is made in the same way as isthe cast 18 of FIGS. 1 and 2. The major difference between cast 30 andcast 18 is that in the former there is no stockinette materialsurrounding the patients arm except underneath the two ends of the cast.A little less than half of each piece of edge-wrap material, symbolizedby the numeral 32a, bears against the patients arm, and a little lessthan half of the material, symbolized by the numeral 32b, is embedded inthe cast material. The remainder of the material 32 forms a cuff-likeedge 32c. Between the edge pieces, cotton 22 is in contact with thepatients skin 16.

There are several advantages in using two lengths of edge wrappingmaterial rather than a cylindrical stockinette. The edging of myinvention is easier to apply because it does not have to be rolled overthe entire area to be immobilized; it need only be wrapped around thetwo regions of the patients arm in the vicinity of the ends of the castto be formed. It is also easier to remove the cast when that is requiredbecause, unlike the prior art, it is not necessary to cut thestockinette and possibly cause pain to the patient in the process.Cotton 22, which is in contact with most of the skin beneath the cast,is more absorbent than the stockinette type material, and thereforethere is less accumulation of perspiration on the skin. Also, since theedge wrapping is cut to suit the circumferential length to which it isbeing applied, the resulting fit, when properly executed, is a closematch. Prior art stockinettes have predetermined diameters which may notprecisely fit the part.

One problem with the prior art cast of FIGS. 1 and 2 is that foreignmaterial often enters under the cast at its edges, i.e., betweenstockinette material 20 and skin 16. Such material can cause irritationand at times significant soft tissue damage as it bears against the skinunder the cast. The patient generally has no way of relieving suchirritation. This problem can be overcome by utilizing an edge wrappingsuch as that shown in FIGS. 5 and 6. Along the center line of the edgewrapping 36 there is a strip 38 of foam rubber or other suchcompressible material which can form a seal around the ends of the cast,or at openings in the cast, and the patients skin. When the cast ismade, the edge map ping is first placed around the part to beimmobilized in the vicinity of the ends of the cast or where there is anopening in the cast, with the foam rubber seal 38 or similarcompressible material separated from the patients skin by the wrappingmaterial. After cotton 22 is applied (see FIG. 6) followed by theinitial layer or layers of plaster 24, the outer edge 36b of the edgewrapping is folded back and embedded in the plaster; additional plasterlayers may then be applied. In addition to cuff 360, there results acircumferential seal of compressible material which prevents penetrationof liquids and other foreign materials into the cast. An adhesive canalso be part of the wrapping in contact with the patients skin tofurther insure the prevention of material entering the space between thepatients skin and the lining of the cast. The adhesive material also isuseful in holding the edge wrapping in place when initially applying itto the desired areas.

FIG. '7 depicts a combined edge wrapping and splint 50. Splint 56 ismade of firm rubber or similar material and may have a soft absorbentmaterial (not shown) on that part of the splint which is in contact withthe patients skin. The splint serves to support the toes (or the fingersin the case of an arm or hand cast) of a patient being fitted with acast requiring a splint in addition to the cast. The edge wrappingmaterial 52 is fixed to splint 56 (e.g., by adhesive), or the edgewrapping material and splint may be made in one unit. The edge wrappingmaterial is provided with two slits 54 which serve to define twofoldable edges 52a. The slits allow the edges to be folded back as willbe described below. The splint 56 can be cut to conform exactly to thespecifications required, i.e., it may be cut to conform to one, two,three, or all fingers and toes. It may also be cut to end precisely atthe tips of the fingers or toes, or to extend for a distance beyond thetips. The splint may also be made of or have incorporated into it amalleable material to allow it to be molded to the curvature of thefingers or toes to allow for further protection or immobilization. Themalleable material in the splint may also be used to form a curlededging around the tips of the fingers or toes for further protection,and may be used to support that portion of the foot or hand with whichit comes in contact. The resultant support has the additional effect ofmaking the cast more comfortable. Adhesive material 52d is used to holdthe edge wrapping in place.

In the first step of making a cast for the foot, shown in FIG. 8, thesplint 56 is placed under the patients foot 60 and the edge wrappingmaterial 52 is wrapped around the patients foot as shown. Thereafter,cotton 22, or similar soft material is placed around the patients footas shown in FIG. 9, followed by the application of plaster material 24,as shown in FIG. 10. After the first layers of plaster have beenapplied, edges 52a are folded back over the plaster, as symbolized byarrow 64 in FIG. 11. Provision of slits 54 allows the edges of the stripto be folded back even though the splint is secured to the strip.Finally, as shown in FIG. 12, additional plaster 24 is applied so thatthe edges 52a of the wrapping are embedded therein. This results inportion 52b of the edge wrapping being in contact with the skin, andportion 520 forming a cuff as previously described. The upper end of thecast of FIGS. 8-12 is not shown, but it can be made by using an edgewrapping strip as shown in FIG. 5. The major advantage of the combinededge wrapping and splint 50 of FIG. 7 is to minimize the time requiredfor applying a splint in that one can utilize a single element for bothproviding support for the patients foot, toes, hand or fingers, and anedge wrapping for the cast.

Although the invention has been described with reference to particularembodiments, it is to be understood that these embodiments are merelyillustrative of 5 the application of the principles of the invention.For example, a strip of foam rubber or other compressible material canbe used in the combined edge wrap and splint of FIG. 7 to provide theseal discussed in connection with the embodiment of FIG. 5. It is alsocontemplated that the edge wrapping of FIG. 5 could be proangled ribwhich would stand upright from that part of the patient to which thecast is being applied and which would define a cast edge. In general, byproviding an edge wrap at each end of the cast, my invention provides noseparation between the absorbing cotton layer and the patients skinalong the major length of the cast as was required in the prior art byreason of a nonfunctional stockinette or any other type of material. Theedge wrap of my invention is easier to apply and to remove than thestockinette of the prior art. It also may be modified to prevent theentrance of foreign material between the cast and skin, which waslacking in the prior art. It also may be modified to provide a splintwhich can be used in conjunction with a cast, and it can be providedwith a flange to define the edges of the cast and make the applicationof the cast easier. Thus, it is to be understood that numerousmodifications may be made in the illustrative embodiments of theinvention and other arrangements may be devised without departing fromthe spirit and scope of the invention.

What I claim is:

l. A method of making a cast comprising the steps of:

a. wrapping a length of edge wrapping material around at least one areaof a patients body part at which an end of the cast is to be formed,

b. applying a layer of absorbent material around and in contact with thepatients body part and which partially covers said length of edgewrapping material,

c. applying a layer of hardenable material around said absorbentmaterial, and I d. folding back the uncovered edge of said length ofedge wrapping material and embedding it in said layer of hardenablematerial.

2. A method of making a cast in accordance with claim 1 wherein saidlength of edge wrapping material has a sealing strip attached theretoalong its length in the central region thereof, which sealing strip ismade to bear against the patients body part in step (a) in the vicinityof said one end of the cast to be formed.

3. A method of making a cast in accordance with claim 1 wherein a splintis secured to said length of edge wrapping material which extends beyondthat edge of the length of edge wrapping material which is folded backin step (d) to provide support for at least a portion of the body partfor which the cast is being made.

4. A method for making a cast in accordance with claim 3 wherein saidlength of edge wrapping material includes two slits on opposite sides ofsaid splint for alloying part of said length of edge wrapping materialto be folded back in step (d).

5. A cast comprising a length of edge wrapping material adapted to bewrapped around at least one area of a patients body part at a respectiveend of the cast, a layer of absorbent material adapted to be placedaround and in contact with the patients body part and which partiallycovers said length of edge wrapping material, and a layer of hardenablematerial around said absorbent material, the edge of said length of edgewrapping material which is not covered by said absorbent material beingfolded back and embedded in said layer of hardenable material.

6. A cast in accordance with claim 5 wherein said length of edgewrapping material has a sealing strip attached thereto along its lengthin the central region thereof, which sealing strip is adapted to bearagainst the patients skin in the vicinity of said one end of the cast.

7. A cast in accordance with claim 5 wherein a splint is secured to saidlength of edge wrapping material which extends beyond that edge of thelength of edge wrapping material which is folded back to provide supportfor the portion of the body part surrounded by the cast.

1. A method of making a cast comprising the steps of: a. wrapping alength of edge wrapping material around at least one area of apatient''s body part at which an end of the cast is to be formed, b.applying a layer of absorbent material around and in contact with thepatient''s body part and which partially covers said length of edgewrapping material, c. applying a layer of hardenable material aroundsaid absorbent material, and d. folding back the uncovered edge of saidlength of edge wrapping material and embedding it in said layer ofhardenable material.
 2. A method of making a cast in accordance withclaim 1 wherein said length of edge wrapping material has a sealingstrip attached thereto along its length in the central region thereof,which sealing strip is made to bear against the patient''s body part instep (a) in the vicinity of said one end of the cast to be formed.
 3. Amethod of making a cast in accordance with claim 1 wherein a splint issecured to said length of edge wrapping material which extends beyondthat edge of the length of edge wrapping material which is folded backin step (d) to provide support for at least a portion of the body partfor which the cast is being made.
 4. A method for making a cast inaccordance with claim 3 wherein said length of edge wrapping materialincludes two slits on opposite sides of said splint for alloying part ofsaid length of edge wrapping material to be folded back in step (d). 5.A cast comprising a length of edge wrapping material adapted to bewrapped around at least one area of a patient''s body part at arespective end of the cast, a layer of absorbent material adapted to beplaced around and in contact with the patient''s body part and whichpartially covers said length of edge wrapping material, and a layer ofhardenable material around said absorbent material, the edge of saidlength of edge wrapping material which is not covered by said absorbentmaterial being folded back and embedded in said layer of hardenablematerial.
 6. A cast in accordance with claim 5 wherein said length ofedge wrapping material has a sealing strip attached thereto along itslength in the central region thereof, which sealing strip is adapted tobear against the patient''s skin in the vicinity of said one end of thecast.
 7. A cast in accordance with claim 5 wherein a splint is securedto said length of edge wrapping material which extends beyond that edgeof the length of edge wrapping material which is folded back to providesupport for the portion of the body part surrounded by the cast.